A 10-year-old moderately mentally retarded girl presented with the pupillary abnormality shown.  Her visual acuity is right eye 20/60 and left eye 20/40.

1.	The most likely diagnosis in this case is:  d -- This is a typical case of persistent pupillary membrane.  In fetal life, vascular structures at the center of the pupil nourish the lens.  These regress in later fetal life leaving a clear pupil.
2.	This child could have:  c -- The obstruction to the pupil could cause a child like this to have deprivation amblyopia.  In addition, persistent pupillary membrane can be associated with cataract.
3.	The most appropriate management of this case would include:  b -- In this case, the best treatment is no treatment.  The child should simply be followed and observed for any changes with treatment dictated by any changes that occur.  Because of the strong likelihood of amblyopia being the cause for the poor vision, excision of the membrane would not be likely to improve vision and in addition, this surgery would carry the risk of creating a cataract or other damage.